Stem Cell–Enriched Fat Grafts Versus Autologous Fat Grafts for Facial Reconstruction: A Systematic Review and Meta-analysis : Annals of Plastic Surgery

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Transplantation Surgery and Research

Stem Cell–Enriched Fat Grafts Versus Autologous Fat Grafts for Facial Reconstruction

A Systematic Review and Meta-analysis

Karam, Mohammad MBChBa; Abul, Ahmad MBChBb; Wood, Benjamin MBChBc; Kahlar, Narvair MBChBd; Naik, Anish MBChBe; Tay, Jing MBChBf; Rahman, Shafiq MBChBg; Matteucci, Paolo MBChBh

Author Information

From the aFarwaniya Hospital, Kuwait City, Kuwait

bDivision of Surgical and Interventional Sciences, University college London

cDepartment of Plastic Surgery, Sheffield Teaching Hospitals, Sheffield

dSWBH Trust, West Midlands

eJames Cook University Hospital, Middlesbrough

fDepartment of Plastic surgery, Bradford Royal Infirmary

gDepartment of Plastic Surgery, Pinderfields General Hospital, Mid Yorks

hDepartment of Plastic Surgery, Hull Royal Infirmary, Hull, United Kingdom

Received October 18, 2022, and accepted for publication, after revision March 10, 2023.

M.K. and A.A. contributed equally as joint first authors.

Conflicts of interest and sources of funding: none declared.

The data sets generated and analyzed during the current study are available from the corresponding author on reasonable request.

M.K. and A.A. contributed equally to the manuscript as joint first authors. M.K. and A.A. contributed in the data analysis and interpretation. L.T., A.N., and M.K. were responsible for the acquisition of data. A.A. and N.K. were responsible for bias assessment of included studies. All authors were responsible for drafting the manuscript. S.R. and M.K. contributed to the study concept and design. S.R. and P.B. supervised the study. All authors read and approved the final manuscript.

Reprints: Ahmad Abul, MBChB, Farwaniya Hospital, Kuwait City, Kuwait. E-mail: [email protected].

Annals of Plastic Surgery 90(5):p 487-493, May 2023. | DOI: 10.1097/SAP.0000000000003553

Abstract

Objective 

The aim of the study is to compare the outcomes of stem cell-enrichment fat grafting versus routine fat grafting for facial reconstruction purposes.

Methods 

A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses Guidelines and a search of electronic information was conducted to identify all randomized controlled trials, case control studies, and cohort studies comparing the outcomes of stem cell enrichment fat grafting versus routine fat grafting for facial reconstruction purposes. Volume retention and infection rate were primary outcome measures. Secondary outcome measures included patient satisfaction postsurgery, redness and swelling, fat necrosis, cysts, as well as operation time. Fixed and random effects modeling was used for the analysis.

Results 

Eight studies enrolling 275 subjects were selected. There was a significant difference between the stem cell enrichment fat grafting and routine grafting groups in terms of mean volume retention (standardized mean difference, 2.49; P < 0.00001). However, there was no significant difference between the 2 groups in the rate of infection (odds ratio, 0.36; P = 0.30). For all secondary outcomes, the intervention group had similar results compared with the control group except for the operation time, which was shorter in the latter.

Conclusions 

Stem cell–enriched fat grafting is a superior option when compared with the routine fat grafting for facial reconstruction surgery because it improves the mean volume retention and does not worsen patient satisfaction and surgical complications.

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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